Table 1.

Types of Patients Transference and Possible Responses of the Therapist

Type of Transference	Examples of Typical Thoughts	Emotional Reactions	Examples of Typical Behaviour	Possible Therapeutic Reactions
Admiring-dependent	The therapist is fantastic. She’s the only person who really understands me, and I will never get out of this without her help.	Enthusiasm and admiration repeatedly change. There is a fear of abandonment.	Frequent complaints and expressions of independence. Giving gifts, praise therapist, flattery, They need a lot of praise, rewards and support. They often require advice, explanation, and care.	Asking about needs and plans, but not advising but encouraging free choice. Empower the patient to create their own homework. Empathic confrontation of dependent behaviour, mapping its origin, discussing the advantages and disadvantages of dependent attitudes, and discussing the free goals of behaviour in the imagination.
Admiring - Independent	The therapist is an excellent professional, just like me. He will certainly enjoy working with an intelligent patient. I am glad I found such a specialist, even though I know most things he tells me. In the end, it’s all up to me.	Euphory, pride, arousal	He/she likes to compete and compare himself in sessions with a therapist. He/she enjoys expressing opposite attitudes and discusses philosophy, fashion, culture, and politics with the therapist. Invites therapist to a “good lunch”. Frequently changes the theme of the session, competes, emphasizes his/her originality and independence	Empathic confrontation of competitive and demonstrative tendencies, empathy with the vulnerable feelings beneath them. Normalization of hypercompensation, mapping of their roots, and then a discussion of the positive and negative consequences of the behaviour. Mapping similarities with behavior outside therapy. Want homework assignments; discuss obstacles.
Moderate positive	The therapist is nice to me, and she wishes the best for me and understands me. She is a good professional.	Hope	Adherence to the therapy, be open, active, make home experiments and exercises	Empower the patient, continue therapy without changes in the approach
Aggressive	I have to show that I am strong; otherwise, he will do what he wants with me. I will not let me chop wood! Either I win or he. How dare he! I have to defend myself!	Fear, anger	He speaks with an angry voice, angrily faces, blames, reproaches, threatens	Validate anger. Let her ventilate within limits. Ask what triggered her. Provide empathic feedback on the anxiety or helplessness that is behind it. Let the patient know that the therapist understands his feelings. Let him express his anger with the help of negative questioning and assertive consent. Then discuss the unmet needs and attitudes behind it, including mapping the causes of these attitudes.
Erotic	It would be great if she wanted me. She must be a great partner. I feel like making love to her, and she is so charming and yet intelligent. She will save me.	Intense desire to be with a therapist, difficulty concentrating on working in a session for feelings of infatuation and desire.	He is flirting with a therapist, wearing expressive clothes, emphasizing interesting things about himself, long sighs, loving sights to the therapist, interest in her partnership, and preferences.	If the intensity is mild, there is no need to address it if it does not affect the course of therapy. In this case, it usually subsides. However, if this transmission blocks therapy, it is necessary to address this topic in a session, go through the associated cognitions, realize their influence on behaviour, and then discuss resources in unmet needs in the past. The therapist needs to express sensitively but firmly that he is willing to cooperate therapeutically but is not interested in a close personal relationship.
Shy	The therapist can criticize me, hurt me, and make fun of me. He rejects me and leaves me when he finds out who I am.	Shame, fear, helplessness	He/she cannot look the therapist in the eye. He/she has trouble entrusting a therapist with painful events. He/she carefully does his/her homework for fear of criticism. He/she often talks about not deserving attention; he/she is incompetent. He often apologizes, he explains.	Easily terminates therapy prematurely. It needs a therapist’s accepting and unobtrusive attitude and empathy for fear and mistrust. Encouragement and step-by-step action are needed. A relationship is important to normalize and empathetically confront. Praise gently and truthfully every attempt at openness and courage.
Suspicious	The therapist is doing this to me on purpose. He wants to hurt and abuse me. He’s against me, and I have to watch it. He has hidden motives; he does not play fair.	Fear, anxiety, anger	It retracts and closes. He does not talk about himself at all or only very superficially. It can be indirectly aggressive, not doing homework. He often falls out of therapy.	Provide empathic feedback, discuss the situation openly, help examine where sensitivity comes from, and go through relationships where it also occurs — map out reasonable attitudes, their pros and cons, and their impact on behaviour — experiment with confidence.
Competitive	I know that; I have heard it many times. I have tried what he’s telling me, and it was useless. He’s no better than me. I know many things better than she does, and he underestimates and teaches me. However, I know a lot better than she does.	Frustration, tension, anger, pride, envy	She competes with a therapist. He discusses fiercely the need to “be right.” He does other things than are agreed. It is difficult to reach compromises.	Provide empathic feedback on manifestations of competitiveness and confrontation. Express understanding and normalize. Map their origin and occurrence in the past and present. Discuss the advantages and disadvantages in specific situations and the impact on cooperation with therapy.
Contemptuous	He cannot do it. He is weak and stupid. How could he help me who does not?	Pride, contempt, impatience, anger	The patient despises psychotherapy and a therapist who throws away what the therapist is doing. He refuses to do his homework, leave a session or stop attending therapy.	Provide empathic feedback on specific behaviours. Explore thoughts and attitudes. You find their origins, Find out how they work in different situations, the behavior they lead to, the pros and cons for life and relationships and what they mean for therapy.
Jealous	Why he/she prefers another patient it’s unfair. He/she gave her/him ten minutes more than me! Why am I worse for him/her? He/she prefers.	Tension, anger, helplessness	Withdrawal or regret. Occasionally there are outbursts of rage. I am measuring session time (others and himself/herself) and monitoring the expression of the therapist’s favour towards others and comparing oneself.	I am asking about thoughts related to helplessness and anxiety. Express understanding and use guided discovery to map the consequences. Elicite angry thoughts, emotions and behaviors. Help identify the origins, maintenance factors, and affection to behaviours, emotions, and relationships in various life situations.
Possessive	They are paid to help me. They must always be available to me because they must help me. I do not care that they have a family, and they should have chosen another profession.	Feelings of pride and smell alternate with anger and anxiety depending on the therapist’s behaviour.	The patient is urgent, controlling, and often domineering. He calls very often, and they are skipping a session. However, he gets angry when the therapist is unavailable to him, and he often blames reproaches.	Explore emotions, thoughts and attitudes. Find out the primary emotions and cognitions before anger—express understanding for them while giving empathetic but firm feedback on behaviour. Find the origins of attitudes and injuries in the past (the need to control protects against the fear of abandonment). Map similar behaviour outside of therapy and identify its advantages and disadvantages.